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DA -7A ' NEBRASKA <br />Rev. 7-66 DEPARTMENT OF PUBLIC WELFARE <br />Certificate of Award <br />Aid to the Abed, BMW or Disabled <br />..... <br />HN No......1tC?-3729— 3 <br />Name..........-, '=.is...F?oUr-t.......................................,...........................................................Age........�1. <br />Address...................................................................................................................................................................... <br />City..............'`3 >in'��n Alebr.........................:.._............... � ' 1- <br />.SS No ....3:...r�.`�........:.................. <br />I:q ..................................................Original Payment S ..... �NT.... Date ....2-1-52............... <br />County.........:.:`.... <br />Legal description of real estate owned by recipient: <br />5o. 251 of Lots 7 Fe Sj DD: 5., Vi.Ut fi e of i?oniphans <br />Han Co., Vebr• <br />/ <br />.............................::............................................................. <br />............................ L....... <br />................ ; • / <br />Signature o[ Payee , State Director <br />003909 <br />State of Nebraska t <br />J 88 <br />County of Hall <br />Entered on Numerical Index and filed <br />for record in uffsce of register of <br />Leeds on the 28th__ day of <br />OCT 28 l 06 PM's�i 0ctobezly*65 at <br />S <br />T <br />I Na � tA� eS o'clock m nutes Pr__ 1Y1• <br />J and recorded in Book _.3 of <br />V JACO N. <br />Ctt.-4f- at e.5$ _....... <br />ea is ------------ <br />Register o , eeds <br />By-------------------------- - <br />Fees $-- --- <br />no -ch-9. Deputy <br />- <br />�� <br />L—=f <br />